Angiomax 250 mg (Bivalirudin)

Angiomax is a prescription drug manufactured by The Medicine Company. It is also known as Bivalirudin. It is a direct thrombin inhibitor indicated for use as an anticoagulant in patients. It is for use as an anticoagulant in patients with unstable angina undergoing percutaneous transluminal coronary angioplasty (PTCA).

1. Undergoing percutaneous coronary intervention (PCI) with provisional use of glycoprotein IIb/IIIa
   inhibitor (GPI)
2. With, or at risk of, heparin-induced thrombocytopenia (HIT) or heparin-induced thrombocytopenia
   and thrombosis syndrome (HITTS), undergoing PCI
3. With unstable angina undergoing percutaneous transluminal coronary angioplasty (PTCA)

Recommended Dose

Angiomax is for intravenous administration only.

Angiomax is intended for use with aspirin (300-325 mg daily) and has been studied only in patients receiving concomitant aspirin.

For patients who do not have HIT/HITTS

The recommended dose of Angiomax is an intravenous (IV) bolus dose of 0.75 mg/kg, followed by an infusion of 1.75 mg/kg/h for the duration of the PCI/PTCA procedure. Five min after the bolus dose has been administered, an activated clotting time (ACT) should be performed and an additional bolus of 0.3 mg/kg should be given if needed.

GPI administration should be considered in the event that any of the conditions listed in the REPLACE-2 clinical trial description.

For patients who have HIT/HITTS

The recommended dose of Angiomax in patients with HIT/HITTS undergoing PCI is an IV bolus of 0.75 mg/kg. This should be followed by a continuous infusion at a rate of 1.75 mg/kg/h for the duration of the procedure.

For ongoing treatment post procedure

Continuation of the Angiomax infusion following PCI/PTCA for up to 4 hours post-procedure is optional, at the discretion of the treating physician. After four hours, an additional IV infusion of Angiomax may be initiated at a rate of 0.2 mg/kg/h (low-rate infusion), for up to 20 hours, if needed.

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
• slow heart rate;
• increased blood pressure (severe headache, blurred vision, buzzing in your ears, confusion, shortness of breath);